 Welcome to the Dr. Gundry podcast. Today we are talking about fat, specifically the type of fat you should be eating for your health and longevity. And to join me today we've got Dr. James Nicolt Antonio, boy that's a good name, who actually is the co-author with a brand new book called Super Fuel and he's the co-author with my good friend Dr. Joseph McCollum. So welcome to the podcast today. Thanks for having me. So he's an internationally known and respective research scientist. He's actually spent a decade studying the effects of different fats on the body and I might add and I hope we'll get to it the effect of salt on the body. So you talk about a couple of great controversial topics they have on the Gundry podcast. I couldn't have picked a better author. So Super Fuel talks about the ketogenic keys to unlock the secrets of good fats, bad fat, and great health. Okay so come on now your body doesn't need fat. I mean Dr. Esselson would tell you don't need fat. Dr. T. Kahn Campbell would tell you don't need fat. Come on doc what's the deal? Give me the straight. Well what's interesting is you know a lot of people that are doing the ketogenic diet actually think all fats the same like they don't really decipher really good fats from bad fats a lot of time and so really the reason why I wrote this book was to really dive deep and try to understand is there a difference between let's say the fat in an avocado or the fat in wild seafood and let's say the fats in bacon or butter and it turns out there is a big difference and so you know really that's what the book is all about trying to pick the healthiest foods that provide the fats to actually make you a better fat burning machine. So you mean there is a difference I shouldn't eat a stick of butter every day if I'm on a ketogenic diet that's that's not good for me? Correct I mean I'm honestly in a thunder of that like a few years ago I was probably putting too much heavy cream in my coffee and I started gaining weight and so that's when I realized I need to really research the different types of fats to see how they metabolize in your own body. So just take for example omega 3 fats they actually increase your fat burning genes in the liver so if you and I are sitting here and we're consuming 3 or 4 grams of omega 3 from let's say fish oil or we're getting it from wild seafood we are literally our beta oxidation our fat burning in the liver is 20% higher and if we're exercising our beta oxidation in our liver or our fat burning goes up by 30% simply by consuming more omega 3's and so it's almost like if you swap out and replace butter with omega 3's it's almost like swapping out a V4 engine for a V8 engine you are literally more efficient and better at burning fat and so that's just one key that really super fuel dives into so I'm glad you brought up omega 3's and you know you mentioned salmon so there's a lot of confusion particularly I take care of a lot of vegan and vegetarian patients and a ton of them use a lot of flaxseed oil because it is a short chain omega 3 and when I measure their omega 3 index which looks at DHA and EPA it's in the it's in the toilet they have no DHA and EPA so tell me a little bit about so what's the difference between a short chain omega 3 and a long chain omega 3 and our health right so what you're referring to what vegans and vegetarians are mostly consuming is the plant omega 3 which is called alpha linolenic acid and so our bodies do have an ability to convert that to the longer chain quote unquote marine omega 3's EPA and DHA but it's not very efficient at doing that so to give you an example only about you know 5 or 10 percent of the ALA that you're getting is going to convert to EPA and only about 0.5 percent is going to convert to DHA so unless you're a woman of child bearing age you're not a good converter of these plant omega 3's to these marine omega 3's and you know really DHA is one of the most important fats for the brain I mean every third fat in the brain is DHA and it's important for eye health as well and so if you're not consuming DHA at least from an out like an algae oil so you can get it from you know a quote unquote vegetarian vegan type of source but it is missed I'm glad you brought that up that's an important fact that a lot of people aren't getting in their diet yeah and I have my particularly my vegans take the algae DHA and it's just great but your point I want to really stress because I bring this up repeatedly in the longevity paradox my new book that our brain is anywhere from 60 to 70 percent fat and of that fat DHA is is about half of that fat and there's some beautiful studies in humans looking at MRIs of brain size and of the hippocampal size the memory centers and people who have the highest omega 3 index have the biggest brains and the largest memory centers and people who have the lowest levels of DHA and EPA have the most shrunken brains and the smallest areas of memory and that goes back I'm old enough to remember that my mother said that fish was brain food and so I would assume that you and Dr. McCullough would say the same thing yeah absolutely I mean when you think about it we actually through an evolutionary times I go through this in super fuel I was almost curious myself DHA so important where would we have gotten it in Africa like how did we obtain DHA and in fact because animals besides hyenas can get at the skull in the brain of their their kills we were we had access to this basically great source of DHA that no other animal besides the hyena could get to and so there's sites in Africa over two million years ago where our ancient ancestors are literally just surrounded by cracked open skulls and to give you an example of how high the DHA content is of brain it's 30% more concentrated than salmon and so we had this source of DHA for millions of years and that's partly why it's so important for brain health and why we have so much of it in our brain because we had a really good access to it not just through seafood but also through literally brain so you're not telling me to go eat some brains tonight no no I'm not but it it goes to the fact that your body has had access to this quote-unquote marine omega-3 for millions of years and so we've evolved on actually adequate intake even when we aren't near a coastline got you okay so in general these long chain omega-3 fats we can get from deep water fish we can get from krill and we can get from you know molecularly distilled fish oil are you everybody talks to me and they said oh my gosh you know fish oil there's tons of heavy metals in fish oil and that's a dangerous thing any thoughts on that yeah I think there is somewhat of a concern not really with fish oil per se a lot of it gets filtered out I would say though wild seafood you do need to make sure you're sourcing it correctly I mean there are clean waters in Canada Alaska New Zealand and other areas but there are obviously other areas that are much more contaminated so kind of my philosophy is I eat wild seafood twice a week and on days I'm not consuming wild seafood the other days I'm consuming high doses of krill oil to get that healthy astaxanthin which is a healthy carotenoid and as well as choline it's very high in phosphatidyl choline which is important for the brain and then also I consume high doses of omega-3 fish oil so I combine both of them but you don't really need to worry about really heavy metals in fish oil I mean some fish oils you might need to worry about the oxidation product so I keep my fish oil in the freezer to prove it won't a real true fish oil will not freeze in the freezer and it's that this is what the fish use in their cell membrane so they don't freeze in cold water people always get shocked at me like dr. D you put your fish oil in the freezer absolutely it actually significantly reduces it from oxidizing so I wouldn't really more worry about the contamination of fish oil I do worry though more a little bit more about the oxidation of it okay so we're gonna we're gonna leave fish oil but we gotta we gotta lay one to rest so this past week big study once again showed that fish oil is worthless for cardiovascular health as well as vitamin D is worthless what say you okay so that study was the vital study and they tested only 840 milligrams of EPA and DHA which is a very low dose so less than a gram of active omega-3 and we had a study that came out and the same day the full results came out of the reduced it study where they I've been publishing for a decade that they weren't giving a high dose of omega-3 but in reduced it they finally gave four grams of EPA and so the reduced it study did show a significant 25% reduction in cardiovascular events and if you actually look at vital there was a significant benefit on the primary endpoint and those who consumed less than 1.5 fish meals per week but people that were eating more than one and a half fish meals per week they didn't see that benefit but that makes sense if you're already consuming fish adding a little bit of omega-3 fish oil isn't going to do any benefit but if you are consuming a lot of fish per week then you did there was a significant about 20% reduction in the primary endpoint and about a 50% reduction in heart attacks and death from heart attacks she's very important yeah and I think that's really important that the devil is in the details and you know those of us who write and review the literature the abstract tells you one thing but you got to get the paper and see what it actually says and sensationalism works really good as headlines so it's actually far more exciting to say fish oil doesn't work than to say fish oil is is pretty good for you right yeah exactly okay so we'll leave omega-3's let's talk about the other fat omega-6 and everybody kind of hears you know you got to have a balance of omega-3 and omega-6 or omega-6's are bad for you give me your take on omega-6's yeah I think if you're getting omega-6's or which is linoleic acid is the parent omega-6's which gets eventually converted to arachidonic acid as it gets elongated in the body if it's coming from whole foods that's that's okay because the whole food like in a nut or a seed is gonna have a coating protecting that very unstable omega-6 fat from oxidizing in your in the acidity of your stomach and it's gonna have vitamin e to protect the linoleic acid or the omega-6 from oxidizing so nature is very smart it packages highly unstable fats you know in a seed or a nut or some other type of substance and puts vitamin e there the problem is is with these heart healthy vegetable oils they have been already oxidized because you can't just squeeze a cotton seed or you can't squeeze a soy bean and you get a lot of oil out of it it requires heavy machinery hexane solvents high heat and so those vegetable oils that you're told to cook with they're already oxidized before you even start cooking them and you're in your pan and so and then you start cooking omega-6's heart healthy vegetable oils you oxidize them further you consume them in the gut and your own acid starts oxidizing them and then you absorb these omega-6 fats and what's really I think you'll really appreciate that there was a study that showed if you give omega-6 to animals it actually grows the bacteria that produces lps whereas if you gave the animals omega-3 the bacteria that would thrive was bacteria that didn't produce lps so it almost goes to show you that this omega-3-6 balance is even controlling your gut microbiome which when I read that I was actually pretty shocked yeah there's actually some very interesting work I talk about in the plant paradox that omega-3's long chain omega-3's actually prevent lps's from appearing in the bloodstream partially because they changed the gut microbiome you're absolutely right but what about what about the evil long chain omega-fat arachidonic acid what what's your thought about it is it is it evil or did it get a bad name it's not evil I mean your brain is also very highly saturated in arachidonic acid the problem is is that arachidonic acid is also very susceptible to oxidation and so it gets a bad rap I think because of that and also because you know animal foods have gotten a bad rap which are high in arachidonic acid and so as long as you can prevent arachidonic acid from metabolizing informing its pro-inflammatory metabolites which omega-3's do then it's not an issue but you there are people with issues that are consuming the linoleic acid creating oxidation in the body and actually oxidizing the arachidonic acid yeah I think that's a really good point it's actually the short chain omega-6 fats they're actually the troublemaker that are potentiating arachidonic acid which you're right is the other important long chain fat in your brain and there's actually a beautiful study out of the University of Texas giving athletes omega-6 fats as a supplement and these guys actually had better athletic performance but shockingly their inflammation levels went down with the addition of these supplements and so I think it's gotten a bad rap quite honestly as long as it comes in the whole package yep all right so now wait a minute dr. D all these healthy vegetable oils you don't mean canola oil as well I mean everybody knows how good that is for your heart well you know in fact canola oil is you know healthier than these hard healthy you know quote-unquote vegetable oils because it's higher in omega-3 but the problem is I still wouldn't consume it and I certainly would never cook with it because again it's still an unstable polyunsaturated fat meaning there's a bunch of double bonds that can oxidize in these fats whereas animal fats are fully saturated they don't have any double bonds that are susceptible to these free radical attacks and so if you want to cook with with an oil canola is probably one of the worst but what actually a lot of people don't realize is extra virgin olive oil is actually one of the best oils to cook with and it because it's so high in polyphenols it completely prevents the oil from oxidizing whereas canola has virtually zero polyphenols and so if you're going to cook with a non-saturated fat like coconut oil or butter which are stable fats if you're going to cook with an unsaturated fat it better have a ton of polyphenols in it like extra virgin olive oil or you're in big trouble yeah it's exactly right in fact there are actually very good published studies that olive oil with stands high heat does not oxidize with high heat and it's one of the hardest things I have to do to convince my patients that it's perfectly safe to cook with olive oil not only perfectly safe but it's one of the better cooking oils it is I mean they literally just did a study comparing olive oil to not only coconut oil which is one of the most highly saturated fat 90% of it is saturated fat coconut oil but also avocado oil as well and in olive oil one extra virgin olive oil had the least oxidation products even compared to coconut oil so it is I mean even though it has a low smoke point a lot of people get this confused they get confused with smoke point and oxidation and so just because something has a high smoke point like canola oil or grapeseed oil does not mean it's not going to oxidize yeah that's exactly right and you know canola oil and grapeseed oil people often hear the word grapeseed and they think of grapeseed extract which is tons of polyphenols but grapeseed oil is devoid of polyphenols it's one of the worst yes it is I mean it's got an omega 6 to 3 ratio of like 700 to 1 yeah it's nasty stuff okay so when when these oils oxidize I tell people think of something going rancid or getting rusty what effect do these oxidized oils have on us why why don't we want that in us yeah well I think it's important to differentiate oxidation of omega 3 in your body versus omega 6 so actually your body has to have a signal to tell itself that it's under attack and that it's being damaged and the signal actually in most of our cells is dha so dha is the alarm system and so when dha oxidizes from you know in your mitochondria let's say your mitochondria are being attacked or you're having inflammation in the brain when dha oxidizes it actually turns on the antioxidant response element and that actually up regulates your own body's endogenous antioxidant systems and so our bodies actually know what to do with oxidized omega 3 it's actually the alarm system to up regulate our own antioxidant system not so with omega 6 when omega 6 oxidizes it forms what's called hydro peroxide and aldehyde basically don't really need to know what those are those are big words but what they do is they cross link proteins basically they make your proteins not work anymore just like there's something called advanced glycation products when you cook let's say your meat and you form advanced glycation products where sugars bond to proteins these fats when they oxidize particularly from omega 6 they basically form basically aggregates with your own protein so proteins in the brain they can form neurofibrillary tangles and so I honestly think that the oxidized omega 6's that people are consuming are literally it's literally one of the number one drivers of chronic disease particularly brain diseases and that's all only happened in the last 50 years when we started eating heart healthy right right exactly okay so uh you I know and uh Dr. McCall are big fans of a of a cyclic ketogenic diet and the book is is very good on doing that why not always be in ketosis and maybe backing up a step what the heck is ketosis and why do you want to be in that a good part of the time yeah well I think we want to almost mimic what we did during evolutionary times and you know really if we were you know hunting for an animal and we couldn't catch it well we would be able to then just eat the plants around us and so we were always somewhat consuming both animal and plant and so we were getting some resistant starch and so which is important and so that feeds your gut bacteria um and so I think that if you're constantly in ketosis and you're never providing your healthy gut bugs the food that they need to thrive and they produce they produce their own fats that benefit you these short chain fatty acids you know butaric acid and it has all these beneficial effects on your arteries and it helps grow colon health and the lining of your gut and all this so if we are more gut genes and more bugs than we are humans right we also want to feed those guys too so just strictly you know limiting carbs to a very very low amount all the time I don't think is really optimal for health so you're not a big fan of the carnivore diet not in particular so describe to me and everybody who's watching or listening what's a so what's a typical day like for you in terms of what you eat or or even you know a week plan I know you mentioned during the two days a week you're eating fish or wild shellfish so give me a give me a glimpse and what's the day in life of Dr. D. Well I mean I'm probably two or three days a week I'll have a couple pastured eggs for breakfast um you know I think it's important to get some type of source of choline so that's a good source for me as well as there's some obviously good healthy crottinoids and vitamins and pastured eggs and iodine and all that other good stuff um but like you said it's wild seafood twice a week and usually wild salmon on days that I'm not doing that I make sure to do the omega three supplements that we talked about krill and fish oil um and then you know I'll try to eat if I can you know maybe eight to sixteen ounces of pastured meat but it doesn't have to be I know some people can't afford pastured meat or grass fed meat and that's okay as long as you're boosting your omega three content through either the wild seafood or the you know the supplements um you know and uh besides that you know some vegetable some type of resistant starch cooked in cool potato is usually what I go go with to feed my healthy gut bacteria um because when you cool when you cool a potato for eight hours you literally quadruple the the the starch um or the resistant starch excuse me so it literally becomes less glucose and more fiber for your healthy gut bugs so I try to integrate that you know three three times a week um so those are some of the foods that I pick so what what I'm hearing is you're not consuming 10 tablespoons of coconut oil every day and another five tablespoons of MCT oil to to achieve ketosis correct no I'm trying to use real whole foods not seeds to um you know every now and then um spinach I love green healthy greens um that's how I try to get my healthy fast it's really just through whole food okay so um why you know Joe McCullough and I have talked about this he you know to his credit often goes all the way as deep as he can on a subject and he tried to stay in ketosis constantly and it clearly had some negative effects on him as as you know as he found out and I would have predicted so and it certainly goes against what we did evolutionary we we clearly were not in ketosis every day um so how do you how do you advise people that you see how do you strike a balance of going in and out of ketosis yeah well I think a lot of people almost confuse ketosis with fat burning and fat loss and so they're so worried about the number on the ketone you know on their ketone levels versus you know what what's really going on with their own health um and so you know exercise is one of the best things to induce ketosis and I think you know the cyclical ketogenic diet that we recommend in superfuel is more so upping carbohydrate and protein intake on days you work out and really that makes sense because carbs are going to increase insulin which is going to help you grow more muscle when you're working out so I think a cyclical type of ketogenic diet where you're integrating more carbs and protein on days you're working out just it makes more sense okay so let me let me in the interest of your time and my time kind of switch thoughts on salt and you're the author of the salt fix and I you know as a cardiologist and a heart surgeon I'm constantly bumping up against my colleagues who have taken away all the salt from all my patients and they're on three or four hypertension drugs and the first thing I do is basically hand them back their iodized sea salt shaker and they you know get this look in their eyes of you know terror and am I doing them a disservice uh how come right well I mean you may you bring up a good point I mean most people view salt as like almost like a poison rather than an essential mineral um and we've been demon I mean the first thing you do if you go to a doctor's office and they take your blood pressure and it's slightly elevated the first thing they're going to tell you is to cut your salt intake right like it's like as if as if everybody should be on a low salt diet but the problem is is there's nuance to everything right and so when you think about that low sodium levels in the blood are literally the most common electrolyte abnormality in the United States over six million people have low sodium levels in the blood and then you start looking at things that cause salt loss so in the book I really started going through well if we didn't get a ton of salt or added salt during evolutionary times why do we need so much nowadays and that was kind of like the question I wanted to answer and caffeine or coffee is one of the greatest salt depleters that you can have and I mean everybody's jacked up on a cup of joe nowadays and if you think about it wait a minute say that again caffeine makes you lose salt yeah not just water not it doesn't just diarrhea you but you lose a ton of sodium and chloride and so if you consume just four cups of coffee you're going to lose about a half a teaspoon of salt and then you think about exercise the average person loses another half of a teaspoon of salt per hour of exercise so the American Heart Association tells you to exercise 60 minutes a day which is going to cause you to lose a half a teaspoon of salt but they tell you to eat less than a half a teaspoon of salt so right away they're contradicting themselves and there's many medications as you said people are on now at the average adult is on four chronic medications most of those are going to be diuretics diabetic medications and almost every single one of those are going to cause salt loss so if I mean there's so many people as soon as they start bringing back healthy salts into their diet they just feel way better um they don't get the dizziness or going to from a seated to a standing position their exercise routine is phenomenally better and so but they've been scared again that salt is bad and it's absolutely not and a point you bring up I think it's fascinating you you say that salt will actually reduce your carbohydrate cravings am I paraphrasing that correctly yeah you nailed it yeah and so so wait a minute so so I'll put some salt in my coffee from now on and then I won't have to have my donut exactly there you go wow fantastic okay yeah so it's really interesting some of these myths get perpetrated without a whole lot of scientific rigor and you're right I mean for instance in palm springs if we're playing tennis in the summer if we're not taking salt tablets uh we are going to end up on the ground in the on the tennis court and yeah and so anybody who wants to eat salt just move to palm springs and you can have all the salt you want there you go not too much of a problem in Rochester in the winter though no all right so um you and Dr. Micola are certainly controversial in saying you ought to eat all these fats saturated fats are good for you avoid these healthy oils what do you say to your critics yeah I mean so I've published numerous papers on this topic and so really the reason why people are so confused is because evidence was buried and is only recently surfaced in the last few years so the researchers that let's say for the for one example one study that just resurfaced from the basement 30 years ago the results were never published it's called the minnesota coronary survey and they looked at thousands of patients and they swapped out animal fats for these vegetable soybean oils and they didn't get the results they wanted so they buried them in a basement for 30 years and luckily they resurfaced and now we know from that study that these heart healthy vegetable oils actually significantly increased heart attacks upon autopsy um and same with another study called the Sydney diet heart study um again there was some data that was buried in that study and that showed the same results there was increases in death when people switched from animal fat to these the high omega six fat a significant increase so we we have the study showing now that they're not heart healthy they're actually worse than animal fat and does it matter what kind of animal fat you're eating do you is it okay to go just get a prime steak that's marbled with fat okay how come that's an animal fat come on yeah so you know you're right so a lot of people are kind of especially carnivore let's say they're going through Wendy's drive through and eating patties and thinking like that's that's healthy for them right the problem is is those those patties are probably deep fried in vegetable oils and they're sourced from an animal that's being fed grain so it's high omega six low and omega three and part of the benefit of this grass fed meat is again these animals are eating grass so they're getting vitamin e and beta carotene and you can literally look at the fat and it'll have like a yellowish orange hue to it from the beta carotene so the the fats from Wendy's burgers versus the fats from a grass fed beef are much different and so there is the nuance again we don't want to lose that in the narrative there is a difference between where you're actually sourcing those animal fat yeah that's a great point i've got a good friend jimmy schmidt who's won three james beard awards and he actually manufactures he has a bunch of wagyu beef that's that's pasture raised grass fed grass finished and the oil he actually gets from those animals is golden color and it's he calls it golden oil and that's all the carotenoids that are in that oil i mean it is it's gold i mean really intensely gold and it's obviously very flavorful so you know if a if a great chef understands this who are we to question that right yeah all right so let me let me just go to that point one more time so what do you what do you say to Dr. Esselstyn when he says you know animal fat is the root of all evil and or any fat is the root of all evil do you say you know he's got some very good results that i respect is he just wrong or is that a good difference of opinion yeah i don't i mean i don't think he's entirely wrong um if you eat bad fats they're going to be bad for you right just like if you eat a bad carb that's going to be bad for you as well so you can do both bad you can do a plant-based diet bad and you can do a carnivore or a high fat diet bad um and that's really what superfuel is about picking and selecting the healthy fats um from whole foods um versus like you said just chugging butter or chugging down heavy cream and thinking that's healthy for you yeah i think that's a great great explanation of what we're all talking about yeah there's i've seen some really bad vegan diets and i've actually seen some some excellent vegan diets um same way i've seen some really good high fat diets and i've seen some most of them are disastrous high fat so i think if we all just kind of set backed up a little bit and said you know and i talk about that in the plant paradox and uh i think there's a lot of good things to recommend that we need to pick from everybody's ideas all right um so before we go uh on this podcast i always answer an audience question and we may uh we may put you in on this one as well so bear with me for a second so gail sends this question in from twitter dr gundry i have been on the plant paradox and feel great well thanks gail i appreciate hearing that can you tell me how i can lose weight while on your plan i have not lost weight on the plant paradox and i would like to while on the plan well gail quite frankly your comment is pretty unusual for people on the plant paradox program there the major complaint if there is one is they can't keep weight on them it keeps getting lower and lower and that's actually one of my biggest questions when i see people in my office who they're clearly following the program all their blood markers are good their inflammation is gone the one thing that seems to be the common factor in people who aren't losing weight is they're eating a lot of resistant starches or they're eating a lot of fruit and unfortunately as as fond as i am of resistant starches for our gut microbiome there is a limit for instance i'll give you an example one of my patients was having plantain pancakes three times a day every day and couldn't understand why he wasn't losing weight in addition to the other foods he was eating and when we reduced his plantain pancakes to things he was going to eat on the weekend the weight started falling off i've had people that eat two or three sweet potatoes every day and when we back them off to a more reasonable so dr. d what do you think is that can we eat too many resistant starches i think yeah but i probably bet you that a lot of those people eating the sweet potatoes were overcooking and not cooling them so they're i do think if you undercook a potato and you cool it it is very difficult to gain weight on those type of potatoes because those are just gigantic fiber bombs but i do agree if you're just eating three sweet potatoes every day and you're not undercooking those and you're not cooling those before you eat them absolutely yeah that's a great point and again thank you gale for asking a lot of people that i see and i've made this mistake myself you know i want a sweet potato and i forget and i come home and i throw it in the oven or i throw it in the pressure cooker and then i'm ready to eat and i don't go to the trouble of throwing it in the refrigerator and i don't i don't think often enough to have a bunch sitting in my refrigerator to reheat so and a lot of people you're right make the mistake of not cooling whether it's the basmati rice whether it's the sweet potato whether it's the jerusalem artichokes not cooling them down and then reheating them or eating them cold yeah great point so i'm glad you're on and gale thanks for answering that okay so dr deat thanks for being on the podcast where can they find you and your book super fuel dr jamesdenick.com i just launched that website and so they can go and get super fuel and the salt fixed on amazon that's probably the easiest place to get at okay and it and this is out now i just came out a few days ago right yeah that's right all right so i've i've read this book i actually made a recommendation for the book it's on the back if you care to read it it's a great book it's very insightful so find super fuel and read it so dr deat thanks again for coming on the program and everybody watching and listening this is dr gundry and i'm always looking out for you we'll see you next week